第五章 研究討論
5.3 幾丁聚醣之角色
幾丁質及其衍生物(如幾丁聚醣)在醫學上的研究顯示有許多的功能，例 如，增強免疫能力、抑制腫瘤、降低膽固醇等；而其在醫材上的應用主要有
46
以下的作用【68】：
一、穩定藥物中的成份
幾丁聚醣具有正電荷可以與藥物中帶負電荷游離脂肪交互作用成乳 劑狀，在這種狀態下的幾丁聚醣與脂肪能形成聚合物(co-polymer)有效的 保護脂肪功能性，以避免藥物中脂肪在高溫滅菌過程中遭到破壞。
二、促進藥物的吸收
研究顯示一些不易被吸收的藥物如atenolol 與幾丁聚醣混合後，經實 驗證明幾丁聚醣可以提升 atenolol 被腸道細胞(Caco-2)的吸收率達 10 到 15 倍。
三、延緩或控制藥物的溶解速度
有些藥物是水溶性或是遇到酸隨即溶解，使得這些藥物無法達到小 腸被吸收而喪失其功效，因此延緩或控制藥物的溶解速率是相當的重 要。經過處理過的幾丁聚醣以不同比例與高水溶性的藥物混合做成錠片 後能有效的延長其溶解時間。
四、幫助藥物送達目的器官
幾丁聚醣具有疏水基與親水基兩種官能基，使得幾丁聚醣能與紫杉 醇(taxol)形成小於 100 nm 的小顆粒膠粒(micelle)，經實驗發現這種形式的 紫杉醇更能有效地送達腫瘤部位，而且與幾丁聚醣混合紫杉醇對腫瘤細 胞的抑制能力較游離態紫杉醇的功效好。
曾有研究指出幾丁聚醣有抑菌的功能，其抑菌機轉有二:一為幾丁聚醣因 具有帶正電陽離子的特性，可和黴菌細胞表面的陰離子結合，導至黴菌細胞 膜的通透性改變,使黴菌細胞內蛋白質，紫外線吸收物質及電解質滲漏而死 亡。 另一抑菌機轉則是幾丁聚醣可藉由甲殼素酵素(chitinase)水解，使其分
子量變小而穿透細菌的細胞核並且和細菌的 DNA 相互反應，來抑制細菌的
mRNA 合成達到抑菌的效果。本研究中發現不論是否交聯的幾丁聚醣海綿底 體，對本實驗所採用之兩種常見之標準細菌均無抑菌效果，唯其真正原因仍
47
有待進一步研究。
本研究中之幾丁聚醣海綿體是立體的構造，雖因經交聯後產生不規則及 表面皺摺之情況，但仍顯示可攜帶並穩定釋放抗生素，且由SEM 觀察到其所 呈現之立體架構，如以往研究所指出的【4、26、28、33、42、44、53、92、
93】，應有利於細胞接觸及生長。
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第六章 結論
經三聚磷酸交聯後之含有四環黴素之幾丁聚醣結構架體可穩定持續釋放
四環黴素至11 天。因此，我們認為，以含有四環黴素之幾丁聚醣海綿體經三
聚磷酸交聯後可以作為牙周炎治療之材料，總結其特點如下：
一、具生物相容性，可被人體吸收
二、可有效的攜帶及穩定的釋放藥物，並有較長的釋放時間 三、抑菌效果明顯
四、立體架構有利於組織再生工程 五、預期具有臨床操作簡易性 六、具創新性及廣泛應用之潛力
唯其應用於醫療之實際效果，仍有待更進一步之生物體研究。如前述本 研究之限制所言，後續研究應以不同模式之幾丁聚醣、不同濃度之四環黴素、
不同之抗生素及針對牙周致病菌為研究標的。
49
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